Provider Demographics
NPI:1205028040
Name:SCHEMENAUER, STEPHEN A (PA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:SCHEMENAUER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1955
Mailing Address - Country:US
Mailing Address - Phone:740-525-8664
Mailing Address - Fax:
Practice Address - Street 1:2910 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-2519
Practice Address - Country:US
Practice Address - Phone:304-428-1900
Practice Address - Fax:304-428-1976
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363A00000X
WVWV01039363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid
OHPENDINGMedicare PIN